NPIMap

Organization Active NPI

Simon Madorsky M.D a Medical Corporation

  • Facial Plastic Surgery Physician
  • Orange, CA
National Provider Identifier
1548407455
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
A50075 Issued in CA
Legal business name
SIMON MADORSKY M.D A MEDICAL CORPORATION
Practice address
1140 W la Veta Ave
Suite 515
Orange, CA 92868-4223
Phone
(714) 953-6928
Fax
(714) 543-8804
NPI assigned
Jan 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Simon J Madorsky, M.D
Title
Owner
Phone
(714) 543-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YS0123X A50075 CA Primary

Addresses

Primary practice location

1140 W la Veta Ave
Suite 515
Orange, CA 92868-4223

Mailing address

PO Box 15788
Newport Beach, CA 92659-5788
Phone (949) 574-4638

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327968000000",
    "number": "1548407455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15788",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926595788",
            "telephone_number": "949-574-4638",
            "fax_number": "949-574-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W LA VETA AVE",
            "address_2": "SUITE 515",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684223",
            "telephone_number": "714-953-6928",
            "fax_number": "714-543-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMON MADORSKY M.D A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-14",
        "last_updated": "2012-01-31",
        "status": "A",
        "authorized_official_last_name": "MADORSKY",
        "authorized_official_first_name": "SIMON",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-543-2000",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CA",
            "license": "A50075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.